Family-related health promotion. Legal framework and the relevance of successful transitions

Background. Health behaviour is substantially determined and shaped by early childhood experiences within the family environment. However, as a constitutionally protected social space, families are not obliged to follow specific health behaviour standards or to take part in preventive measures. This means that the family cannot be seen as a setting, as described in the prevention law (PravG) and the intervention logic of the setting approach is not directly applicable to the family environment. Objectives. The purpose of the article is to explore the new challenges for family health promotion arising from the PravG prevention law. Methods. The article analyses the new family-related statutory regulations of PravG including the relevant actors, responsibilities and intersecting regulation issues taking into account the federal child protection law (Bundeskinderschutzgesetz) adopted in 2012. The article then goes on to define requirements for health promotion in families derived from the Ottawa Charter. In the final section, the transition approach is applied, considering relevant factors for health promotion especially around childbirth and identifying needs and enabling factors for health promotion in the family environment. Results. Family health promotion should be designed as a common task of health services, child and youth services and other local actors. The three core strategies of the Ottawa Charter-Advocate, Enable and Mediate-are suitable to guide the process. "Prevention Chains" are coordinated actor networks constructed to assist families in the promotion of health and the management of transitions. The PravG creates a new role for medical prevention management and for communities to become the "umbrella setting" for health promotion. Discussion. Family health promotion is a complex challenge for actors involved in providing and supporting health services, those in the local environment and at the steering level. It requires an independent research-based intervention approach including the identification of adequate methods and clearly acknowledged institutional responsibilities.